Dinner parties, weddings, vacations, and nights out with friends. These are just a few examples of common activities that often involve or encourage the consumption of alcohol. But just how prominent is drinking culture in Canada? Well, an estimated 80% of Canadians consume alcohol (1). Amongst those who drink, nearly six million engage in heavy drinking (2). For females, this translates into drinking four or more alcoholic beverages during one event, at least once a month, while for males, that number is five or more drinks (3). Heavy drinking can lead to the development of alcohol use disorder, a behavioural condition that gives rise to cognitive, emotional, and physical issues that increase disability and decrease lifespan (4-7).
A diverse collection of treatment options, such as medications, psychological therapies, and recovery support programs, exist to help those struggling with alcohol misuse and dependence achieve and maintain abstinence (4;6). In particular, recovery support programs are appealing because they are widely available and often offered at little to no cost (6;8;9). Alcoholics Anonymous (AA), a group-based 12-step program that focuses on peer-to-peer support and is delivered within community settings, is one example of this type of service (6;10). Overtime, AA has inspired the development of professionally-led Twelve-Step Facilitation (TSF) programs whose main goal is to connect people to AA groups in their community (6;11).
We know that these types of programs are popular. So, should you join the millions of folks using them or advocate their use to loved ones? A recent systematic review took on the task of evaluating the effects of these programs in people battling alcohol use disorder, alcohol abuse, or alcohol dependence (6).
What the research tells us
It was found that people engaging in peer-led AA/professionally-led TSF programs that follow standardized guidelines for delivery are anywhere from 3% to up to 42% more likely to abstain from alcohol use compared to people using other recognized treatments—such as cognitive behavioural therapy (e.g., CBT). These AA/TSF programs may also be as effective as other recognized treatments—such as CBT—in reducing alcohol-related consequences (e.g., mental, physical, and social impacts). Additionally, AA/TSF programs may potentially be more beneficial or equally as beneficial for outcomes such as percentage of days abstinent (long-term), drinking intensity (e.g., drinks consumed per drinking day or percentage of days heavy drinking), and addiction severity. However, our confidence in the findings for these last three outcomes is quite low given the small number of studies and the small number of participants, so more research is needed before more definitive conclusions can be drawn.
These results, coupled with the likelihood that community support programs are more easily accessible than other treatment options, illuminate why AA and similar interventions are indeed popular and worth a try or suggestion to a loved one (6). If you’re personally in need of support, speak with your health care provider about suggestions for programs or search online for ones available in your community. You might find that many in-person programs have been cancelled due to the ongoing COVID-19 pandemic. However, many of them are being offered virtually though platforms like Zoom instead.
